The 19th century in America was an era of tremendous change. An industrial revolution ignited the country, while the Civil War divided the nation. During this time, most of the mentally ill were housed in private homes and poorhouses. As populations increased, this was becoming impractical. State legislators in South Carolina pushed for a state-operated hospital to care for and provide treatment for the mentally ill.
In 1821, South Carolina legislators passed a bill to finance a state hospital for the insane and admitted its first patient in 1828. Typically, the hospital would only accept patients who were wealthy enough to pay for their care. A few African-Americans, mostly slaves, were admitted during the first 20 years. The hospital rooms faced south to provide fresh air and had hidden hinges and locks to give a less prison-like feel. The asylum is also one of the first fireproof structures built in the United States.
By the 1850s, the average patient paid $250 annually. A separate eating area costs another $100. The indigent were admitted for an annual fee of $135, billed to the patient’s local government. As more poor people became accepted, the costs became harder to collect, and the asylum depended more on state funding.
During the Civil War, funding significantly decreased. The superintendent opposed turning the campus into a prisoner-of-war camp. Although the Confederate Army did not get the asylum, the grounds were used as a prison camp for Union troops from October 1864 to February 1865. When Union General William T. Sherman occupied Columbia, residents fled to the asylum for refuge. The superintendent opened the doors and allowed residents to seek shelter, even using his funds to provide them with food and other necessities.
The architects who designed and constructed each section of the building modeled it off of Dr. Thomas Kirkbride’s system. Dr. Kirkbride was an influential doctor from Pennsylvania, who developed multiple institutions. His “Kirkbride System” consisted of repeated blocks linked together on each side of a central administration building, as well as open gardens, plenty of windows, gas lighting, segregation by gender, and no subterranean patient housing.
Initially, they quartered men and women on different floors, later in separate buildings. In 1858, after the Babcock Building was complete, male patients moved in. Each wing is four floors with rooms split into manageable wards. The oldest portions of the building are the north and south wings. The north wing housed male patients and female patients in the south wing.
Even with the Babcock Building, the facility reached the capacity of 192 patients by 1860. Many families preferred to care for their mentally ill relatives at home, or even in the county jail as opposed to the state hospital. After South Carolina assumed direct responsibility for mentally ill patients in 1871, many of the county jails transferred patients to the state hospital. By 1900, the asylum’s population ballooned to over 1000. Sadly, 30% of the patient population died each year.
During the early 1900s, thousands of Americans were becoming sick and dying of a mysterious disease known as pellagra. The symptoms of pellagra included diarrhea, skin diseases, depression, seizures, and dementia. Many sufferers of this disease found themselves in these state-operated asylums, a convenient place to warehouse people. Due to overcrowding, conditions were beyond deplorable, and patient care was nonexistent.
By 1914, asylum physicians had determined the cause to be a vitamin b3 or niacin deficiency. A coalition of asylum superintendents from all over the United States along with local health officials organized several meetings here to discuss the infectious disease. One doctor hypothesized poverty was part of the problem, and malnutrition could be directly linked to the disease. Other physicians were skeptical that germs did not play a more significant role.
To prove his theory, the doctor orchestrated “filth parties” where he, along with his wife and assistants, injected themselves with blood, ingested scabs, bodily fluids, and feces of patients. No one developed pellagra. He also did decisive experiments with Mississippi prison inmates, who volunteered in exchange for a full pardon. The doctor fed the inmates a poor diet and within a few months, many of them developed the disease. He then added fresh vegetables, meats, and milk to their diet and reversed all of the signs and symptoms of pellagra.
The 20th century brought significant changes to the state hospital. The superintendent realized the need for community health clinics. He pushed for programs to educate the public about mental illness, including its causes and methods of care. The first permanent outpatient clinic in Columbia opened in 1923. The success of the clinic inspired the opening of travel clinics throughout South Carolina.
During the 1950s, the discovery of phenothiazine controlled many of the symptoms of mental illness, allowing the wards to be unlocked and patients to roam more freely. The introduction of Medicaid and other social welfare programs in the 1960s helped spur a large-scale relocation of patients to community-based mental health centers. In 1964, the Department of Mental Health was created as an independent agency to assist South Carolina with research, mental health education, professional training, along with other community services.
By the end of the 1970s, patient’s rights became a key role in the renewed emphasis on caring for the mentally ill. In 1985, a U.S. Department of Justice report noted that conditions at the asylum were “flagrantly unconstitutional.” The Justice Department entered into a four-year decree to provide increased funding for all patients at the state-operated hospital. By the 1990s, wards were slowly being closed. Soon, entire floors were abandoned, as patients were discharged to group homes or local care facilities.
Just after 6:00 PM on December 13, 2018, the Columbia Fire Department was called to the old hospital with reports of a fire coming from the Barringer Building. Upon arrival, the CFD discovered the historic Babcock Building ablaze. Fire crews could see flames coming from the roof of the south wing. The two-alarm fire is under investigation.